Liu Tao, Liu Xin, Li Yue, Wang Aitian, Chen Shuohua, Wu Shouling, Hou Shike, Fan Haojun, Cao Chunxia
Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People's Republic of China.
Department of Intensive Medicine, Kailuan General Hospital, Tangshan, People's Republic of China.
Clin Epidemiol. 2023 Mar 13;15:325-336. doi: 10.2147/CLEP.S399920. eCollection 2023.
Empirical data on the association between traumatic injury and abnormal glucose metabolism risk is limited. This study aimed to investigate the association between traumatic injury and abnormal glucose metabolism.
This study included 153,162 participants in the Kailuan Study from 2006 to 2013. Participants with abnormal glucose metabolism at baseline were excluded. All participants were monitored every two years until December 31, 2019. During follow-up, 1915 subjects with a first traumatic injury (defined as a physical injury caused by an external force) were identified. For each subject with traumatic injury, one control subject was randomly selected and matched for age (± 3 years) and sex. A total of 3830 subjects were included in the final analysis. Cox proportional hazards models were used to examine the association between traumatic injury and the subsequent risk of abnormal glucose metabolism.
During a median follow-up of 6.91 (3.57-9.41) years, 990 abnormal glucose metabolism events occurred. After adjustment for demographics, lifestyle behaviors, and traditional risk factors, those who had traumatic injury compared to controls were 32% more likely to develop any abnormal glucose metabolism (hazard ratio [HR] 1.32; 95% confidence interval [CI]1.16-1.49), including impaired fasting glucose (IFG) (HR 1.29; 95% CI 1.12-1.48) and diabetes (HR 1.37; 95% CI 1.10-1.70). The risks for abnormal glucose metabolism, IFG, and diabetes in subjects with moderate-severe injury were higher than in subjects with mild injury for the 1-year follow-up period, while the association was not significantly different by injury severity for the whole follow-up period.
Traumatic injury was associated with an increased risk of abnormal glucose metabolism. However, the risks of outcome events decreased as the follow-up period extended. Improved short- and long-term prevention and management strategies for controlling glucose are needed for individuals with traumatic injury.
关于创伤性损伤与异常糖代谢风险之间关联的实证数据有限。本研究旨在调查创伤性损伤与异常糖代谢之间的关联。
本研究纳入了开滦研究中2006年至2013年的153,162名参与者。排除基线时糖代谢异常的参与者。所有参与者每两年监测一次,直至2019年12月31日。在随访期间,确定了1915名首次发生创伤性损伤(定义为由外力导致的身体损伤)的受试者。对于每例创伤性损伤受试者,随机选择一名对照受试者,并按照年龄(±3岁)和性别进行匹配。最终分析共纳入3830名受试者。采用Cox比例风险模型来检验创伤性损伤与随后异常糖代谢风险之间的关联。
在中位随访6.91(3.57 - 9.41)年期间,发生了990例异常糖代谢事件。在对人口统计学、生活方式行为和传统风险因素进行调整后,与对照组相比,发生创伤性损伤的受试者发生任何异常糖代谢的可能性高32%(风险比[HR]1.32;95%置信区间[CI]1.16 - 1.49),包括空腹血糖受损(IFG)(HR 1.29;95% CI 1.12 - 1.48)和糖尿病(HR 1.37;95% CI 1.10 - 1.70)。在1年随访期内,中重度损伤受试者的异常糖代谢、IFG和糖尿病风险高于轻度损伤受试者,而在整个随访期内,损伤严重程度与风险的关联无显著差异。
创伤性损伤与异常糖代谢风险增加相关。然而,随着随访期延长,结局事件风险降低。对于创伤性损伤个体,需要改进控制血糖的短期和长期预防及管理策略。